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Training and Technology Combine to Save Lives in Iraq

WASHINGTON, April 20, 2007  Expanded training in combat life-saving procedures has enabled a greater than 98 percent survival rate for U.S. troops injured in Iraq, a coalition surgeon said yesterday.

These skills, combined with improved communications technology and a robust air evacuation support network, mean soldiers are surviving traumatic injuries at an unprecedented rate, Army Lt. Col. Jason Wiemann told online journalists.

Speaking from Iraq, the Multinational Division Baghdad surgeon said major advances over past conflicts have been made in the speed of care for the wounded.

“It’s often 30 minutes from time of injury until the patient’s in an operating room being treated by a surgeon,” Wiemann said. However, treatment in the first 30 minutes is “all up to his buddies in the field and the training that they’ve had,” he noted.

The most recent iteration of that training, known as the Improved Combat Life Savers Course, was unveiled in October 2005 to teach emergency “skills to non-medical soldiers based on the injury patterns that we’ve been seeing during this conflict,” Wiemann said.

“We’ve added several, fairly advanced medical procedures to the repertoire of the non-medical soldier,” he noted. They involve “decision-making skills for treating casualties when they’re under fire, when they’re not under fire, and during the evacuation process.”

Army personnel identified three main types of injuries afflicting U.S. troops in Iraq and shaped the training around those, Wiemann explained. The injuries include massive bleeding from extremity wounds, trauma to the chest cavity in which air pockets develop, and obstruction of airways.

To treat such injuries, Wiemann said, soldiers are trained in the use of pressure bandages, tourniquets, nasal airway tubes, needles, litters, and hemostatic dressings designed to create “an almost instantaneous clot” on areas of arterial bleeding. Hemorrhagic bleeding, in particular, Wiemann noted, has previously been “very difficult to manage in the field.”

Despite the importance of rapid, superficial treatment at the time of injury, getting wounded troops to medical treatment facilities remains vital to their survival, Wiemann said.

“When we’ve taken all these skills and we’ve coupled them with the fact that the air mobile evacuation assets within theater have never been paralleled in the history of warfare,” the surgeon noted, “we can generally have a helicopter to the site in less than 15 to 20 minutes, and often have a patient to an advanced surgeon within 30 minutes to an hour after an injury.”

Soldiers are now surviving wounds that in the past they “would’ve been lucky to survive if they happened right next to a major trauma center,” he said. “A lot of these are due to the combat life savers.”

Meanwhile, Wiemann said, U.S. forces are also engaged in training the Iraqi army in basic combat lifesaving.

The goal is “to make as many of the Iraqi army familiar with basic first aid as possible,” he explained, “and eventually … get into the same level of training as we do with the American army.”

Extensive work has been done to bring the Iraqi military medical system up to speed and build medical competency within the Iraqi force, he said.

“Very few of the Iraqi casualties end up in (American) facilities now,” Wiemann noted.

At the same time, the surgeon said U.S. reconstruction efforts have focused on water and sanitation projects meant to improve Iraq’s deteriorated, and in some places nonexistent, public health infrastructure.

“That’s a big part of what our goals are,” Wiemann said, “repairing the infrastructure of the country to include sanitation grids, water supplies, garbage pickup. There’s entire programs based around improving the sanitation of Baghdad.”

Progress toward those goals has been impeded in part by the security situation, Wiemann said.

“It seems to be a common practice with the insurgents that they like to attack such things because it does create such an impact, but headway is being made constantly in those areas,” he noted.

And despite injuries, setbacks, and even mental health issues, Wiemann said, the majority of U.S. troops remain positive on their mission in Iraq.

“The good that’s going on here is evident to everyone here,” Wiemann said. “It doesn’t get played up as much as it potentially could, but everybody has wonderful stories … of schools being rebuilt, hospitals being rebuilt, children running up on the street playing with the soldiers.

“Most soldiers are in the Army because they wanted to be soldiers,” he said. “We pre-select ourselves for the fact that this was our calling in life, that we’re here to serve the country.”

(Tim Kilbride is assigned to New Media, American Forces Information Service.)